13
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Clozapine and Long-Term Mortality Risk in Patients With Schizophrenia: A Systematic Review and Meta-analysis of Studies Lasting 1.1–12.5 Years

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Patients with schizophrenia have an elevated mortality risk compared to the general population, with cardiovascular-related deaths being the leading cause. The role of clozapine use in the long-term mortality risk is unclear. While clozapine treatment may increase the risk for cardiovascular mortality, it may have protective effects regarding suicidal behavior.

          Related collections

          Most cited references36

          • Record: found
          • Abstract: found
          • Article: not found

          Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level.

          Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in developed countries. Moreover, specific patient, provider, treatment and system factors act as barriers to the recognition and to the management of physical diseases in people with SMI. Psychiatrists can play a pivotal role in the improvement of the physical health of these patients by expanding their task from clinical psychiatric care to the monitoring and treatment of crucial physical parameters. At a system level, actions are not easy to realize, especially for developing countries. However, at an individual level, even simple and very basic monitoring and treatment actions, undertaken by the treating clinician, can already improve the problem of suboptimal medical care in this population. Adhering to monitoring and treatment guidelines will result in a substantial enhancement of physical health outcomes. Furthermore, psychiatrists can help educate and motivate people with SMI to address their suboptimal lifestyle, including smoking, unhealthy diet and lack of exercise. The adoption of the recommendations presented in this paper across health care systems throughout the world will contribute to a significant improvement in the medical and related psychiatric health outcomes of patients with SMI.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Clozapine Response Rates among People with Treatment-Resistant Schizophrenia: Data from a Systematic Review and Meta-Analysis

            Clozapine is the most effective antipsychotic for the 25% to 33% of people with schizophrenia who are treatment resistant, but not all people achieve response. Using data from a previously published clozapine systematic review and meta-analysis, we explored the proportion of people who achieved response and examined the absolute and percentage change in Positive and Negative Syndrome Scale (PANSS) scores. Overall, 40.1% (95% confidence interval [CI], 36.8%-43.4%) responded, with a mean reduction in PANSS of 22.0 points (95% CI, 20.9-23.1), a reduction of 25.8% (95% CI, 24.7%-26.9%) from baseline. These reductions are clinically meaningful. A 40% response rate to clozapine suggests that 12% to 20% of people with schizophrenia will be ultra-resistant. La clozapine est l’antipsychotique le plus efficace pour les 25 à 33% des personnes souffrant de schizophrénie qui sont réfractaires au traitement; toutefois, les personnes n’obtiennent pas toutes une réponse. À l’aide des données d’une revue systématique et d’une méta-analyse publiées précédemment, nous avons exploré la proportion de gens qui obtenaient une réponse, et examiné le pourcentage absolu et les changements de pourcentage dans les scores à l’échelle des syndromes positifs et négatifs (PANSS). Globalement, 40,1% (IC à 95% 36,8% à 43,4%) ont répondu, avec une réduction moyenne à la PANSS de 22,0 points (IC à 95% 20,9 à 23,1), une réduction de 25,8% (IC à 95% 24,7% à 26,9%) par rapport au départ. Ces réductions sont cliniquement significatives. Un taux de réponse de 40% à la clozapine suggère que de 12% à 20% des personnes souffrant de schizophrénie seront ultra-réfractaires.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found
              Is Open Access

              Antipsychotics and mortality in a nationwide cohort of 29,823 patients with schizophrenia

                Bookmark

                Author and article information

                Journal
                Schizophrenia Bulletin
                Oxford University Press (OUP)
                0586-7614
                1745-1701
                April 25 2018
                April 25 2018
                Affiliations
                [1 ]Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef, AZ Amsterdam, The Netherlands
                [2 ]Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY
                [3 ]Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY
                [4 ]Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
                Article
                10.1093/schbul/sby052
                6403051
                29697804
                b44ceb7b-9cac-498d-995a-888d00654971
                © 2018

                https://academic.oup.com/journals/pages/about_us/legal/notices

                History

                Comments

                Comment on this article